Prosthetic intervertebral disc replacement in the lumbar spine (IPG306)
The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on prosthetic intervertebral disc replacement in the lumbar spine.
Artificial intervertebral discs have been developed to act as a functional prosthetic replacement unit for intervertebral units in much the same way as prostheses have been developed for a variety of joints such as the hip or knee. The design of most prosthetic discs is similar, with two metallic endplates separated by a more pliable inner core designed to emulate the biomechanical properties of the nucleus pulposus. The implantation of the prosthetic discs involves a small incision below the umbilicus. The diseased disc is partially or fully excised (depending on the prosthesis used). The vertebral endplates and surrounding spinal ligaments are preserved and help maintain implant stability. Single discs can be replaced, or alternatively, several levels can be replaced during the same surgery.
The standard intervention for patients with these indications would be discectomy and spinal fusion.
There are specific codes available within OPCS-4 to classify lumbar, thoracic and cervical disc replacement; one of the following codes is used depending on the site of the procedure:
V36.1 Prosthetic replacement of cervical intervertebral disc
V36.2 Prosthetic replacement of thoracic intervertebral disc
V36.3 Prosthetic replacement of lumbar intervertebral disc
An additional code will also be added from category V55.- to specify the number of levels of spine operated on.
Note: Codes within category V55.- are assigned in second place each time a spinal operation is coded, if the levels of spine are not specified V55.9 Unspecified levels of spine is used.
The NHS Classifications Service of NHS Connecting for Health is the central definitive source for clinical coding guidance and determines the coding standards associated with the classifications (OPCS-4 and ICD-10) to be used across the NHS. The NHS Classifications Service and NICE work collaboratively to ensure the most appropriate classification codes are provided. www.connectingforhealth.co.uk/clinicalcoding
- IPG306 Prosthetic intervertebral disc replacement in the lumbar spine: guidance (web format)
- IPG306 Prosthetic intervertebral disc replacement in the lumbar spine: consultation comments
- Prosthetic intervertebral disc replacement in the lumbar spine (interventional procedures consultation)
- Prosthetic intervertebral disc replacement in the lumbar spine (interventional procedures overview)
This page was last updated: 19 June 2012
- Web format
- Full Guidance (PDF)
- IPG306 Amnewid disgiau wedi'u treulio yn rhan isaf asgwrn y cefn â disgiau artiffisial: deall canllawiau NICE (fformat MS Word)
Information for the public
Implementation tools and resources
- None available
The summary of the key recommendations in the guidance written for patients, carers and those with little medical knowledge and may be used in local patient information leaflets.
Quick Reference Guide
The quick reference guide presents recommendations for health professionals
The published NICE clinical guidance, contains the recommendations for health professionals and NHS bodies.
The published full clinical guidance for specialists with background, evidence, recommendations and methods used.